Prevalence of obstructive sleep apnea in patients with arterial hypertension
DOI:
https://doi.org/10.17533/udea.rfnsp.e356041Keywords:
obstructive sleep apnea, risk factors, arterial hypertensionAbstract
Objective: To estimate the prevalence of obstructive sleep apnea in patients diagnosed with arterial hypertension.
Methods: Cross-sectional study in 449 patients diagnosed with arterial hypertension from the Chronic Patients Care and Follow-up Program of the State Social Enterprise Hospital of El Tambo, Cauca. The Epworth sleepiness scale and the STOP-bang test, previously validated, were administered.
Results: The study population had a mean age of 67 years, with 67.3% being women. The mean body mass index was 26.8, the mean neck circumference was 36 cm, the mean waist circumference was 96 cm, and 23.6% had moderate daytime sleepiness, while 5.3% had severe sleepiness. The mean number of antihypertensive medications used was 2, and 7.1% had uncontrolled hypertension. A STOP-bang test score of 3 or higher was found in 32.8% of participants. The STOP-bang test was positive for obstructive sleep apnea in subjects with uncontrolled blood pressure (p = 0.006); body mass index greater than 35 kg/m2 (p = 0.035), number of antihypertensive medications (p = 0.004) and abdominal circumference (p = 0.007). In the generalized linear model analysis, the adjusted prevalence ratio was calculated and revealed moderate sleepiness. Being a man older than 50 years, having a larger neck circumference and abdominal circumference, and age are important associated risk factors for uncontrolled hypertension.
Conclusions: A prevalence of obstructive sleep apnea of 32.8% was found in hypertensive patients, a figure higher than that of the general population.
Downloads
References
Lv R, Liu X, Zhang Y, et al. Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome. Signal Transduct Target Ther. 2023;8(1):218. DOI: https://doi.org/10.1038/s41392-023-01496-3
Parejo-Gallardo KJ. Definición del síndrome de apnea-hipopnea obstructiva del sueño (SAHOS). Rev. Fac. Med. 2017;65(Supl. 1):S9-10. DOI: https://doi.org/10.15446/revfacmed.v65n1Sup.59718
Heinzer R, Vat S, Marques-Vidal P, et al. Prevalence of sleep-disordered breathing in the general population: The
HypnoLaus study. Lancet Respir Med. 2015;3(4):310-8. DOI: https://doi.org/10.1016/S2213-2600(15)00043-0
Lyons MM, Bhatt NY, et al. Global burden of sleep-disordered breathing and its implications. Respirology. 2020;25(7):690-702. DOI: https://doi.org/10.1111/resp.13838
Torre L, Vázquez-García JC, Muiño A, et al. Prevalence of sleep related symptoms in four Latin American cities. J Clin Sleep Med. [internet]. 2008 [citado 2024 feb. 1]; 4(6):579-85. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2603536/
Escobar-Córdoba F, Quijano-Serrano M, Calvo-Gómez JM. Evaluación del insomnio como factor de riesgo para suicidio. Rev Fac Cien Med Univ Nac Cordoba. 2017;74(1):37-45. DOI: https://doi.org/10.31053/1853.0605.v74.n1.14740
Polanía-Dussán IG, Escobar-Córdoba F, et al. Validación colombiana del cuestionario de Berlín. Rev Fac Med. [internet]. 2013 [citado 2024 feb. 1]; 61(3):231-8. Disponible en: https://www.redalyc.org/pdf/5763/576363535003.pdf
Toledo-Ortiz JL. Validación al castellano del cuestionario STOP-bang [Trabajo de grado]. [Bogotá]: Universidad Nacional de Colombia [internet]; 2018. [citado 2024 feb. 1]. Disponible en: https://repositorio.unal.edu.co/bitstream/handle/unal/62970/1101682448.2018.pdf?sequence=1&isAllowed=y
Chung F, Yang Y, Liao P. Predictive performance of the STOP-bang score for identifying obstructive sleep apnea in obese patients. Obes Surg. 2013;23(12):2050-7. DOI: https://doi.org/10.1007/s11695-013-1006-z
Ruiz AJ, Rondón M, Hidalgo P, et al. Prevalence of sleep complaints in Colombia at different altitudes. Sleep Sci. 2016;9(2):100-5. DOI: https://doi.org/10.1016/j.slsci.2016.05.008
Pei G, Ou Q, Shan G, et al. Screening practices for obstructive sleep apnea in healthy community people: A Chinese community-based study. J Thorac Dis. 2023;15(9):5134-49. DOI: https://doi.org/10.21037/jtd-22-1538
Chica-Urzola H, Escobar-Córdoba F, Eslava-Schmalbach J. Validación de la escala de somnolencia de Epworth. Rev. Salud Pública [internet]. 2007 [citado 2024 feb. 1]; 9(4):558-67. Disponible en: http://www.scielo.org.co/pdf/rsap/v9n4/v9n4a08.pdf
Vicente-Herrero MT, Capdevila-García L, Bellido-Cambrón MC, et al. Presión arterial y síndrome de apnea-hipopnea del sueño en trabajadores. Test STOP-bang frente a la escala de Epworth. Hipertens Riesgo Vasc. 2018;35(1):15-23. DOI: https://doi.org/10.1016/j.hipert.2017.08.004
Mancia G, Kreutz R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens. 2023;41(12):1874-2071. DOI: https://doi.org/10.1097/HJH.0000000000003480
Salman LA, Shulman R, Cohen JB. Obstructive sleep apnea, hypertension, and cardiovascular risk: Epidemiology, pathophysiology, and management. Curr Cardiol Rep. 2020;22(2):6. DOI: https://doi.org/10.1007/s11886-020-1257-y
Nieto FJ, Young TB, Lind BK, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. JAMA. 2000;283(14):1829-36. DOI: https://doi.org/10.1001/jama.283.14.1829
Lavie P, Herer P, Hoffstein V. Obstructive sleep apnoea syndrome as a risk factor for hypertension: Population study. BMJ. 2000;320(7233):479-82. DOI: https://doi.org/10.1136/bmj.320.7233.479
García-Peña ÁA, Ospina D, Rico J, et al. Prevalencia de hipertensión arterial en Colombia según información del Sistema Integral de Información de la Protección Social (SISPRO). Rev. Colomb. Cardiol. 2022;29(1):29-35. DOI: https://doi.org/10.24875/RCCAR.M22000114
Zurique-Sánchez MS, Zurique-Sánchez CP, Camacho-López PA, et al. Prevalencia de hipertensión arterial en Colombia: revisión sistemática y meta-análisis. Acta Méd. Colomb. 2019;44(4):20-23. DOI: https://doi.org/10.36104/amc.2019.1293
República de Colombia, Departamento Administrativo Nacional de Estadística. Estratificación socioeconómica para servicios públicos domiciliarios [internet]. s. f. [citado 2024 feb. 1]. Disponible en: https://www.dane.gov.co/index.php/servicios-al-ciudadano/servicios-informacion/estratificacion-socioeconomica
WHO Consultation on Obesity & World Health Organization. (2000). Obesity: preventing and managing the global epidemic. Report of a WHO consultation [internet]. 2000 [citado 2024 feb. 1]. Disponible en: https://iris.who.int/handle/10665/42330
Espinoza López PA, Fernández Landeo KJ, Pérez Silva Mercado RR, et al. Neck circumference in Latin America and the Caribbean: A systematic review and meta-analysis. Wellcome Open Res. 2021;6:13. DOI: https://doi.org/10.12688/wellcomeopenres.16560.1
Ardila-Ardila E, Hernández-Triana E, editores. Consenso colombiano de síndrome metabólico. Bogotá: Asociación Colombiana de Endocrinología [internet]; 2006 [citado 2024 feb. 1]. Disponible en: https://academia.utp.edu.co/medicinadeportiva/files/2012/04/SINDROME-METABOLICO-ACEndocrinolog%C3%ADa.pdf
Ruiz AJ, Rondón Sepúlveda MA, Franco OH, et al. The associations between sleep disorders and anthropometric measures in adults from three Colombian cities at different altitudes. Maturitas. 2016;94:1-10. DOI: https://doi.org/10.1016/j.maturitas.2016.08.013
Von Elm E, Altman DG, Egger M, et al. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573-7. DOI: 10.7326/0003-4819-147-8-200710160-00010.
R Core Team. R: A Language and Environment for Statistical Computing. Version 4.3.2, 2023-10-31 UCRT. Vienna, Austria: R Foundation for Statistical Computing [internet]; 2023 [citado 2024 feb. 1]. Disponible en: https://www.R-project.org/
World Medical Association (WMA). WMA Declaration of Helsinki - Ethical principles for medical research involving human subjects. Fortaleza: 64th WMA General Assembly [internet]; 2013 [citado 2024 feb. 1]. Disponible en: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/
República de Colombia, Ministerio de Salud. Resolución 8430, por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud (1993 oct. 4).
Yeghiazarians Y, Jneid H, Tietjens JR, et al. Obstructive sleep apnea and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2021;144(3):e56-e67. DOI: https://doi.org/10.1161/CIR.0000000000000988
Vicente-Herrero MT, Capdevila-García L, Bellido-Cambrón MC, et al. Riesgo cardiovascular y obesidad en el síndrome de apnea del sueño valorado con el cuestionario Epworth. Rev Mex Endocrinol Metab Nutr. [internet]. 2107 [citado 2024 feb. 1]; 4(4):167-76. Disponible en: https://www.revistadeendocrinologia.com/files/endocrinologia_2017_4_4_167-176.pdf
Robles A, Gil-Rojas Y, Amaya D, Venegas M, et al. Cost-utility and budget impact analysis of CPAP therapy compared to no treatment in the management of moderate to severe obstructive sleep apnea in Colombia from a third-party payer perspective. Expert Rev Pharmacoecon Outcomes Res. 2023;23(4):399-407. DOI: https://doi.org/10.1080/14737167.2023.2181792
Municipios de Colombia. El Tambo [internet]. 2023 [citado 2024 feb. 1]. Disponible en: https://www.municipio.com.co/municipio-el-tambo-cau.html
Choudhury A, Routray D, et al. Prevalence and risk factors of people at-risk of obstructive sleep apnea in a rural community of Odisha, India: A community-based cross-sectional study. Sleep Med. 2019;58:42-47. DOI: https://doi.org/10.1016/j.sleep.2019.03.014
González-Hernández LM, Castaño-Castrillón JJ, Herrera-García V, et al. Relación entre hipertensión arterial sistémica y síndrome de apnea-hipopnea obstructiva del sueño y sus factores de riesgo asociados, en población hipertensa de un centro médico. Cali (Colombia) 2008. Arch. Med. [internet]. 2008 [citado 2024 feb. 1]; 8(2):89-97. Disponible en: https://www.redalyc.org/pdf/2738/273820368002.pdf
Drager LF, Genta PR, Pedrosa RP, et al. Characteristics and predictors of obstructive sleep apnea in patients with systemic hypertension. Am J Cardiol. 2010;105(8):1135-9. DOI: https://doi.org/10.1016/j.amjcard.2009.12.017
Hou H, Zhao Y, Yu W, et al. Association of obstructive sleep apnea with hypertension: A systematic review and meta-analysis. J Glob Health. 2018;8(1):010405. DOI: https://doi.org/10.7189/jogh.08.010405
Guerrero-Zúñiga S, Gaona-Pineda EB, Cuevas-Nasu L, et al. Prevalencia de síntomas de sueño y riesgo de apnea obstructiva del sueño en México. Salud Publica Mex. 2018;60(3):347-55. DOI: https://doi.org/10.21149/9280
Downloads
Published
How to Cite
License
Copyright (c) 2024 Universidad de Antioquia
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The contents of the articles are the responsibility of the authors
The editorial committee has editorial independence from the National School of Public Health "Héctor Abad Gómez" of the University of Antioquia.
The editorial committee is not responsible for aspects related to copying, plagiarism or fraud that may appear in the articles published in it.
When you are going to reproduce and disclose photographs or personal data in printed or digital format, informed consent is required. Therefore, this requirement is required of the author at the time of receipt of the manuscript.
Authors are responsible for obtaining the necessary permissions to reproduce any material protected by reproduction rights.
The authors preserve the moral rights and assign the economic rights that will correspond to the University of Antioquia, to publish it, distribute electronic copies, include them in indexing services, directories or national and international databases in Open Access, under the Creative Commons Attribution license -Not Commercial-Share Equal 4.0 International Commercial (CC BY-NC-SA) which allows others to distribute, remix, retouch, and create from the work in a non-commercial way, as long as the respective credit and license are granted. new creations under the same conditions.
The authors will sign the declaration of transfer of economic rights to the University of Antioquia, after the acceptance of the manuscript.
The editorial committee reserves the right to reject the articles whose authors do not offer satisfactory explanations about the contribution of each author, to meet the criteria of authorship in the submission letter. All authors must meet the four criteria of authorship according to ICMJE: "a) .- That there is a substantial contribution to the conception or design of the article or to the acquisition, analysis or interpretation of the data. b) That they have participated in the design of the research work or in the critical review of its intellectual content. c) .- That has been intervened in the approval of the final version that will be published.d). That they have the capacity to respond to all aspects of the article in order to ensure that issues related to the accuracy or integrity of any part of the work are adequately investigated and resolved. "
-- 
--
